State agency reinstates 3 health insurers

Scrapping its much-maligned move to cull the number of health insurance carriers available to public employees and retirees, the Group Insurance Commission decided Thursday to go with “Option B.”

The new approach gives GIC members six commercial carriers and four Medicare carriers, as opposed to the three commercial carriers and two Medicare carriers under an earlier approach the commission approved in a Jan. 18 vote, according to the GIC. Harvard Pilgrim Health Care, Tufts Health Plan and Fallon Community Health have all been reinstated as GIC insurance carriers.

The board voted 12 to 2 to switch to Option B. Commissioners Christine Clinard and Tamara Davis, who are both representatives of the public on the commission, voted against the motion and said they continued to favor the earlier approach. Before deciding on Option B on Thursday, the GIC voted by the same margin, 12-2, to reconsider its Jan. 18 vote, with Davis and GIC board chairwoman Valerie Sullivan voting against.

The commission handles health coverage for 436,000 people, and the public employees and retirees who rely on the GIC for care form a potent political constituency. Senate Ways and Means Chairwoman Karen Spilka said Wednesday that the commission’s prior vote “generated more outrage and consternation from constituents than any issue that I can remember over the last, literally, many, many years.”

One group of GIC enrollees will see still their options curtailed under the new plan. Several thousand mostly elderly members, including retired teachers, who are in Pool 2 have six carrier options right now, but will only have one — Unicare, a subsidiary of Anthem — when the changes voted on Thursday take effect July 1. About 950 of them will need to move to Unicare plans because their current carriers did not submit bids, according to the GIC.

GIC officials said they would work with Unicare on structuring plans to give members in Pool 2 options in price and levels of coverage.

There is also not an ironclad guarantee everyone will be able to both keep their doctor and their current insurer under Option B.

“Option B presumes that people who are in a plan — provided that same exact product is offered — will have whatever network is there. What I can’t say for certain, because no one will know, is whether there hasn’t been any changes in a network,” GIC general counsel Andrew Stern told the News Service.

Jim Durkin, a lobbyist for the American Federation of State, County and Municipal Employees, cheered the commission’s reversal Thursday.

“I think it was a major step forward and a big victory for organized labor and for all the men and women who rely on the GIC for quality care,” Durkin told the News Service. He said, “If there’s a silver lining in this catastrophe, it’s that we finally have decision-makers paying attention to a myriad of problems that we’ve had with the Group Insurance Commission for many years now.”

While the earlier approach to consolidate commercial plan offerings would have saved about $21 million, according to the GIC, Option B will save about $1 million. The new approach means the vast majority of members will be able to keep their health insurers, according to GIC officials. The previous plan would have required about 200,000 members to switch carriers.